Health Care and the ACA

This is just my personal opinion not endorsed by anyone in particular. I am not a high level player in the medical system, but I am in the system and I can think and see how things affect our system. There are two separate but related issues I want to discuss.

First our current system. There is much talk of going to a socialized system by both the right and left. The implication that ACA or the left is moving towards a socialized system implies that we have a free market system. We simply do not have either system. We have a hybrid system with components of both. There is the Medicare/Medicaid portion that is partial socialized care and we have an insurance based system that has a small part of free enterprise system and then we have the most free enterprise portions of dental/podiatric/cosmetic medicine where it is more "cash and carry'. As an added complication we have a heavy handed government that makes requirements that may at times work both for and against the best interest of the patient and the medical care industry as a whole. The simplest example is the US Post Office which can't ever seem to get its head above water-not because the Post Office leadership and workers do not know how but because there are so many government regulations and stipulations. You can't run a successful business if some senator requires a post office station in "Nowheresville, TX" like I drove by last week. So medicine is a heavy regulated, but partial free enterprise system. It thus has the efficiency of neither an integrated single payer system nor a free enterprise system.

Next,cost shifting is universal and no one even knows what things cost until after the service has been delivered. The Affordable Care Act/Obamacare is a law intended to expand coverage to more US citizens, presumably without "breaking the budget." The goal of the ACA is initially contrary to its aims. To expand coverage will cost more. The law does little to address the problems of a hybrid system as noted above. The ACA is also an extremely complex bill. It is hard to fault any single party in terms of difficulty with implementation. It is so complex that no one could get it right and have a smooth lead in. Additionally almost any major governmental program will do poorly if a significant number of governmental officials are working against it.

So where do I think this leaves health care? I essentially see it between a rock and a hard place with no good options. The current hybrid system is bulky, inefficient, costly and too large. The ACA probably will not work. If the ACA does work, it still will address the issues of our large complex system. The public in general wants not just medical care, they want it to be the best and to be free. Well maybe not free but with little additional out of pocket costs. Of course this is simply not possible. Proposed options that are simple minded included making Medicare universal, but that will not work. Not at the current level of tertiary and quaternary care that we currently have. Decisions have to be made at what level of universal coverage is given if indeed universal coverage is granted. It seems to me no one has the ability to solve the healthcare problems and no one has the authority to do so.

For me, the goal is always the same-to provide the best healthcare possible and to do so as efficiently and humanely as I can. I will have to let others deal with the rest. Even if many others do not have a clue what they are doing.

A visitor

I live at the end of the road. Corpus is not a table tennis mecca. No one comes through Corpus on the way to somewhere. There is one table tennis club in town and the nearest clubs are in Harlingen or San Antonio and we rarely get visitors. Last night we had a player from Chicago show up at our club. A 1900 level looper. Oh boy was it sweet to play someone a little better than me AND to play someone who plays a different style and is new. It is very easy to get used to playing the same few buys all the time. I lose all the problem solving ability. We all know each others weaknesses and strengths. I also have to initiate attacking or offense. Last night it was fun to have the back and forth of who initiated offense and to play someone who actually looped the ball and did not smash. I was able to have some blocking, some good fishing and an occasional counter loop. I was also able to work on preventing a powerful opening loop and work on spin variation and no spin strategy. Since I have gone to double inverted I need to visit some clubs around the state myself. Equipment wise I played most of the night with maze on FH and tenergy80 on BH of double fish carbon blade. I played El Visitor twice-the first time with my 729 HS champ carbon blade with Juic Nano Spin 2 and kept blocking his loops long from by BH. Lost 0-3 and was down 0-5 or so each game. I choose that blade cause I thought it would have more control, but it was the only match I used it all night. I played him the last match of the evening and won 3-1. Tenergy blocked better and sure pushed better than nanospin and I think either he was tired (looping takes a lot of legs) or he let up. I did play strategically better-varying spin, returning serve much better and even doing a couple of 3rd ball attacks. I also found a serve he did not return well.

Sword Maze

I have been using Sword Maze- on my forehand with either a 729 hao shao (HS) blade (using it on the card side) or on a double fish (DF) chen qi blade (double sided carbon) and have been pleased with the balance between power and control. It has listed a 42 degree sponge-which is less than what I have been using on rubbers in the past. I have various euro/jap rubbers on my BH. Juic Nano Spin 2 on my HS blade (which I used today at the club), Tenergy 80 and Razka 7 on my two DF blades. Having the faster rubber on my BH side is a little non-conventional except for chinese players. I have been tempted to try bluefire M2 or T80 or tibhar evolution on my FH but I am way over budget as it is. I really need to work on consistency and game play with this current combination. It may not be the best, but it feels good and I can play naturally with it. I do have to adjust between blades, but that is more a function of the different BH rubbers.

A long ride

As I get more and more "afeared" of riding on the roads and want to ride more off road I am tempted to do an occasional event ride. There is a ride in honor of Tony Balboa, a local who was killed a few years ago. LINK Although I have not been doing rides that long and been either on the trainer or on trails or my short work commute. I have just become aware of gravel riding which also intrigues me. It uses mostly cyclocross bikes or other non-road race bikes and bigger tires. I first heard about it from another pediatric pathologist who has rode bikes with pretty good success for years. These gravel rides appear to be pretty big on endurance. Things like unsupported 200 mile rides in Kansas (Dirty Kanza 200) in which the first finisher takes 14 hours! Pretty overwhelming. Link to How Will see if I stay off the roads or give one of these rides a try. I still have never done a Century (ok, maybe a metric one but not a real one). Would be fun to do on one of these:

Back to the Blog

I think I may use twitter to link to my blog to explore some more issues that have been on my mind and just do not fit well with 144 characters. Particularly some thoughts on Christianity, theology etc. Looking back I am not sure why I have several posts in decemeber 2012-except they probably are old posts from my phone.